Dataset Information

Manual muscle testing and hand-held dynamometry in people with inflammatory myopathy: An intra- and interrater reliability and validity study.

ABSTRACT: Manual muscle testing (MMT) and hand-held dynamometry (HHD) are commonly used in people with inflammatory myopathy (IM), but their clinimetric properties have not yet been sufficiently studied. To evaluate the reliability and validity of MMT and HHD, maximum isometric strength was measured in eight muscle groups across three measurement events. To evaluate reliability of HHD, intra-class correlation coefficients (ICC), the standard error of measurements (SEM) and smallest detectable changes (SDC) were calculated. To measure reliability of MMT linear Cohen`s Kappa was computed for single muscle groups and ICC for total score. Additionally, correlations between MMT8 and HHD were evaluated with Spearman Correlation Coefficients. Fifty people with myositis (56±14 years, 76% female) were included in the study. Intra-and interrater reliability of HHD yielded excellent ICCs (0.75-0.97) for all muscle groups, except for interrater reliability of ankle extension (0.61). The corresponding SEMs% ranged from 8 to 28% and the SDCs% from 23 to 65%. MMT8 total score revealed excellent intra-and interrater reliability (ICC>0.9). Intrarater reliability of single muscle groups was substantial for shoulder and hip abduction, elbow and neck flexion, and hip extension (0.64-0.69); moderate for wrist (0.53) and knee extension (0.49) and fair for ankle extension (0.35). Interrater reliability was moderate for neck flexion (0.54) and hip abduction (0.44); fair for shoulder abduction, elbow flexion, wrist and ankle extension (0.20-0.33); and slight for knee extension (0.08). Correlations between the two tests were low for wrist, knee, ankle, and hip extension; moderate for elbow flexion, neck flexion and hip abduction; and good for shoulder abduction. In conclusion, the MMT8 total score is a reliable assessment to consider general muscle weakness in people with myositis but not for single muscle groups. In contrast, our results confirm that HHD can be recommended to evaluate strength of single muscle groups.

SUBMITTER: Baschung Pfister P

PROVIDER: S-EPMC5875759 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Manual muscle testing and hand-held dynamometry in people with inflammatory myopathy: An intra- and interrater reliability and validity study.

Baschung Pfister Pierrette P de Bruin Eling D ED Sterkele Iris I Maurer Britta B de Bie Rob A RA Knols Ruud H RH

PloS one 20180329 3

Manual muscle testing (MMT) and hand-held dynamometry (HHD) are commonly used in people with inflammatory myopathy (IM), but their clinimetric properties have not yet been sufficiently studied. To evaluate the reliability and validity of MMT and HHD, maximum isometric strength was measured in eight muscle groups across three measurement events. To evaluate reliability of HHD, intra-class correlation coefficients (ICC), the standard error of measurements (SEM) and smallest detectable changes (SDC ...[more]

PMID: 29596450

Similar Datasets

Project description:Hand-held dynamometry (HHD) has never previously been used to examine isometric muscle power. Rate of force development (RFD) is often used for muscle power assessment, however no consensus currently exists on the most appropriate method of calculation. The aim of this study was to examine the reliability of different algorithms for RFD calculation and to examine the intra-rater, inter-rater, and inter-device reliability of HHD as well as the concurrent validity of HHD for the assessment of isometric lower limb muscle strength and power.30 healthy young adults (age: 23±5 yrs, male: 15) were assessed on two sessions. Isometric muscle strength and power were measured using peak force and RFD respectively using two HHDs (Lafayette Model-01165 and Hoggan microFET2) and a criterion-reference KinCom dynamometer. Statistical analysis of reliability and validity comprised intraclass correlation coefficients (ICC), Pearson correlations, concordance correlations, standard error of measurement, and minimal detectable change.Comparison of RFD methods revealed that a peak 200 ms moving window algorithm provided optimal reliability results. Intra-rater, inter-rater, and inter-device reliability analysis of peak force and RFD revealed mostly good to excellent reliability (coefficients ≥ 0.70) for all muscle groups. Concurrent validity analysis showed moderate to excellent relationships between HHD and fixed dynamometry for the hip and knee (ICCs ≥ 0.70) for both peak force and RFD, with mostly poor to good results shown for the ankle muscles (ICCs = 0.31-0.79).Hand-held dynamometry has good to excellent reliability and validity for most measures of isometric lower limb strength and power in a healthy population, particularly for proximal muscle groups. To aid implementation we have created freely available software to extract these variables from data stored on the Lafayette device. Future research should examine the reliability and validity of these variables in clinical populations.

Project description:BackgroundMaximal isometric muscle strength (MIMS) assessment is a key component of physiotherapists' work. Hand-held dynamometry (HHD) is a simple and quick method to obtain quantified MIMS values that have been shown to be valid, reliable, and more responsive than manual muscle testing. However, the lack of MIMS reference values for several muscle groups in healthy adults with well-known psychometric properties limits the use and the interpretation of these measures obtained with HHD in clinic.ObjectiveTo determine the intra- and inter-rater reliability, standard error of measurement (SEM) and minimal detectable change (MDC) of MIMS torque values obtained with HHD.MethodsIntra and Inter-rater Reliability Study. The MIMS torque of 17 muscle groups was assessed by two independent raters at three different times in 30 healthy adults using a standardized HHD protocol using the MEDup™ (Atlas Medic, Québec, Canada). Participants were excluded if they presented any of the following criteria: 1) participation in sport at a competitive level; 2) degenerative or neuromusculoskeletal disease that could affect torque measurements; 3) traumatic experience or disease in the previous years that could affect their muscle function; and 4) use of medication that could impact muscle strength (e.g., muscle relaxants, analgesics, opioids) at the time of the evaluation. Intra- and inter-rater reliability were determined using two-way mixed (intra) and random effects (inter) absolute agreement intraclass correlation coefficients (ICC: 95% confidence interval) models. SEM and MDC were calculated from these data.ResultsIntra- and inter-rater reliability were excellent with ICC (95% confidence interval) varying from 0.90 to 0.99 (0.85-0.99) and 0.89 to 0.99 (0.55-0.995), respectively. Absolute SEM and MDC for intra-rater reliability ranged from 0.14 to 3.20 Nm and 0.38 to 8.87 Nm, respectively, and from 0.17 to 5.80 Nm and 0.47 to 16.06 Nm for inter-rater reliability, respectively.ConclusionsThe excellent reliability obtained in this study suggest that the use of such a standardized HHD protocol is a method of choice for MIMS torque measurements in both clinical and research settings. And the identification of the now known metrological qualities of such a protocol should encourage and promote the optimal use of manual dynamometry.

Project description:BackgroundInterrater reliability, aka intercoder reliability, is defined as true agreement between raters, aka coders, without chance agreement. It is used across many disciplines including medical and health research to measure the quality of ratings, coding, diagnoses, or other observations and judgements. While numerous indices of interrater reliability are available, experts disagree on which ones are legitimate or more appropriate. Almost all agree that percent agreement (ao), the oldest and the simplest index, is also the most flawed because it fails to estimate and remove chance agreement, which is produced by raters' random rating. The experts, however, disagree on which chance estimators are legitimate or better. The experts also disagree on which of the three factors, rating category, distribution skew, or task difficulty, an index should rely on to estimate chance agreement, or which factors the known indices in fact rely on. The most popular chance-adjusted indices, according to a functionalist view of mathematical statistics, assume that all raters conduct intentional and maximum random rating while typical raters conduct involuntary and reluctant random rating. The mismatches between the assumed and the actual rater behaviors cause the indices to rely on mistaken factors to estimate chance agreement, leading to the numerous paradoxes, abnormalities, and other misbehaviors of the indices identified by prior studies.MethodsWe conducted a 4 × 8 × 3 between-subject controlled experiment with 4 subjects per cell. Each subject was a rating session with 100 pairs of rating by two raters, totaling 384 rating sessions as the experimental subjects. The experiment tested seven best-known indices of interrater reliability against the observed reliabilities and chance agreements. Impacts of the three factors, i.e., rating category, distribution skew, and task difficulty, on the indices were tested.ResultsThe most criticized index, percent agreement (ao), showed as the most accurate predictor of reliability, reporting directional r2 = .84. It was also the third best approximator, overestimating observed reliability by 13 percentage points on average. The three most acclaimed and most popular indices, Scott's π, Cohen's κ and Krippendorff's α, underperformed all other indices, reporting directional r2 = .312 and underestimated reliability by 31.4 ~ 31.8 points. The newest index, Gwet's AC1, emerged as the second-best predictor and the most accurate approximator. Bennett et al's S ranked behind AC1, and Perreault and Leigh's Ir ranked the fourth both for prediction and approximation. The reliance on category and skew and failure to rely on difficulty explain why the six chance-adjusted indices often underperformed ao, which they were created to outperform. The evidence corroborated the notion that the chance-adjusted indices assume intentional and maximum random rating while the raters instead exhibited involuntary and reluctant random rating.ConclusionThe authors call for more empirical studies and especially more controlled experiments to falsify or qualify this study. If the main findings are replicated and the underlying theories supported, new thinking and new indices may be needed. Index designers may need to refrain from assuming intentional and maximum random rating, and instead assume involuntary and reluctant random rating. Accordingly, the new indices may need to rely on task difficulty, rather than distribution skew or rating category, to estimate chance agreement.

Dataset Information

Manual muscle testing and hand-held dynamometry in people with inflammatory myopathy: An intra- and interrater reliability and validity study.

Publications

Manual muscle testing and hand-held dynamometry in people with inflammatory myopathy: An intra- and interrater reliability and validity study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets